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When it comes to health concerns, what's true for women often isn't true for men, but that may not be the case with migraine headaches.

In women, hormonal dips in estrogen and progesterone during menstruation sometimes trigger migraines. Researchers are discovering that low levels of the male sex hormone testosterone may play a role in causing migraine and other types of headaches in men. And in some cases, replacing testosterone may help resolve the headache along with other problems associated with low testosterone -- decreased sex drive, erectile dysfunction, fatigue, and mood changes. Still, the medical literature is far from definitive. In fact, just one small study from the Cleveland Clinic, involving nine men and women, touches on the connection between low testosterone and headache. In the study, men who were treated with testosterone basically were cured of headaches, while women only experienced some relief.

Low-T and Migraine Headaches: The Connection

Joseph Alukal, MD, an assistant professor in the obstetrics and gynecology and urology departments at NYU Langone Medical Center in New York City, said that low testosterone levels are always on his diagnostic radar. “I have heard men say that their headaches had gotten much less frequent after being treated with testosterone replacement therapy for other issues,” he said.

Migraine relief may well be an added benefit for some but not all men with low testosterone. Still, testosterone replacement therapy is hardly a panacea and should be used only when low testosterone levels have been documented. Even then some caveats apply.

“One of the reliable side effects is that it impairs sperm, so if a man wants to have children, I don’t use it,” Dr. Alukal said. Testosterone is also not appropriate for men who have high red blood cell counts. And, there are mixed data on what role testosterone replacement can or should play among men with prostate cancer.

Merle L. Diamond, MD, associate director of the Diamond Headache Clinic in Chicago, always asks about a person’s libido during diagnosis. “Low testosterone has been reported as a cause of headache pain, and sometimes we will test for it,” she said.

And Jed Diamond, PhD, author of the book Men Alive: Stop Killer Stress With Simple Energy Healing Tools and director of the MenAlive men’s health program in Willits, Calif., noted that there's no downside to measuring testosterone levels in men with headache or other health complaints. “This should be done as part of a regular checkup,” he said. “There are all sorts of health problems that are associated with low testosterone, and headache may be one of them. It’s feasible that treating low testosterone in people who are having headaches will improve them.”Low-T and Migraine Headaches: The Future

Although a lot of work remains to be done on this men's health issue, the theory that low testosterone may play a role in the origin of headaches is not at all far-fetched.

"It makes sense because we know that migraines are caused by hormonal changes,” said Spyros G. Mezitis, MD, a New York-based endocrinologist. Still, he said, more study is needed before any blanket statements can be made about what role, if any, testosterone plays in causing or treating migraines in men.